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Utah rates for HCPCS 22862

Revision including replacement of total disc arthroplasty (artificial disc), anterior approach, single interspace; lumbar

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,754.23 / $6,025.60 / $10,964.78
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,041.74 / $2,754.23 / $12,022.64
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,778.28 / $2,754.23 / $5,128.61
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $5,495.41
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25,703.96 / $30,199.52 / $67,608.30
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,019.95 / $3,981.07 / $5,495.41
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,187.76 / $4,897.79 / $7,079.46
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,019.95 / $3,890.45 / $5,495.41
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,311.31 / $5,128.61 / $24,547.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,778.28 / $2,344.23 / $3,715.35